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Browsing by Author "Arvas, Mikko"

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  • Ekroos, Sofie; Karregat, Jan; Toffol, Elena; Castrén, Johanna; Arvas, Mikko; van den Hurk, Katja (2024)
    To prevent blood donors from developing iron deficiency (ferritin <15 μg/l) and subsequent anaemia (haemoglobin <120 g/l), blood services rely on information about known risk factors, including the donor’s sex and age. Menstrual blood loss is not accounted for in blood donation interval recommendations, despite being a known risk factor of iron deficiency. We aim to investigate to what extent menstrual bleeding is associated with ferritin and haemoglobin levels in female blood donors, and whether other menstruation-related factors (i.e. use of hormonal contraception, heavy menstrual bleeding) are associated with risk of iron deficiency or anaemia. The study population consisted of 482 premenopausal and 499 postmenopausal Dutch whole blood donors. Exclusion criteria were current pregnancy, BMI ≥50, ferritin ≥200, PBAC ≥400 and age <18 or ≥70 years. Menstrual blood loss was quantified using a pictorial blood assessment chart (PBAC), a semi- objective method to evaluate the number of used menstrual products and the degree of staining. We identified predictors of log(ferritin)/haemoglobin and iron deficiency/anaemia using Bayesian linear and logistic regression models, and quantified the average percentage of variance in log(ferritin) and haemoglobin explained by the co-variates. Menstrual blood loss explained the majority of the variance in haemoglobin (7.5 %) and second only to the number of days since last donation for ferritin (8 %). Heavy menstrual bleeding (PBAC ≥150, OR = 3.67 [1.52, 8.86]) was associated with anaemia, and use of levonorgestrel-releasing intrauterine device was negatively associated with iron deficiency (OR = 0.06 [0.01, 0.78]). Age was not associated with iron status. Menstrual blood loss and blood donation were the most important determinants of iron status in premenopausal women. Thus, results suggest that accounting for menstrual blood loss in donation interval guidelines may benefit blood donors.